Determination of predictors associated with pain in non­surgically treated adults with idiopathic scoliosis.

BACKGROUND: It is recognized that pain related to adult individuals with idiopathic scoliosis (IS) substantially impacts individuals' daily activities and quality of life. The objective of this study was to identify the possible predictors of pain intensity in non­surgically treated adults with IS. METHODS: This cross-sectional study included 58 adults individuals with Lenke type 1 IS. Participants' sociodemographic characteristics were recorded, and pain severity, curvature severity, trunk rotation angle, disability, spinal mobility, cosmetic deformity perception, and quality of life were assessed. Regression analyses with various models were performed to determine the predictors of pain severity and the best model was selected based on performance criteria. RESULTS: Strong associations were found between pain severity with curvature severity, spinal mobility, trunk rotation angle, perception of cosmetic deformity, disability, and quality of life (p < 0.05). It was observed that Lasso regression was the best model based on the performance criteria considered. According to this model, the primary predictors of pain intensity in adult IS were determined as curvature severity, spinal mobility, trunk rotation angle, cosmetic deformity perception, back-related disability and quality of life, in order of importance. CONCLUSION: In accordance with the findings of this study, which examined for the first time the determinants of pain intensity in adult individuals with Lenke type 1 IS, we suggest that mentioned possible factors affecting and determining pain should be taken into consideration when establishing evaluation and treatment programs.

Validity and reliability of the Turkish Version of the Oral Behaviors Checklist.

OBJECTIVE: The aim of this study was to investigate the validity and reliability of the Turkish version of the Oral Behavior Checklist (OBC-TR). MATERIALS AND METHODS: The study included 223 patients with temporomandibular disorders (TMDs) and 94 individuals without TMD. Face and content validity were analyzed. Structural (with confirmatory factor analysis [CFA]), convergent (with pain intensity, Fonseca Anamnestic Index [FAI], Hospital Anxiety and Depression Scale [HADS], and Oral Health Impact Profile [OHIP-14]), divergent (with active pain-free maximum mouth opening [MMO]), and discriminant validity were investigated to evaluate the construct validity. Cronbach's alpha for internal consistency and the intraclass correlation coefficient (ICC) for test-retest reliability were computed. RESULTS: Face and content validity were satisfactory. The CFA has verified the structural validity of the OBC-TR. Strong associations between the OBC-TR score and pain intensity (r = 0.88), FAI (r = 0.90), HADS (r = 0.82-0.86), and OHIP-14 (r = 0.83) scores, and MMO (r = -0.85) verified the convergent and divergent validity of the OBC-TR. Concerning discriminant validity, the OBC-TR discriminated between patients with TMD and individuals without TMD (p < 0.05). Internal consistency (Cronbach's alpha = 0.89) and test-retest reliability (ICC = 0.91) were satisfactory. CONCLUSION: The OBC-TR is a valid and reliable instrument to measure the frequency of oral parafunctional behaviors in Turkish-speaking patients with TMD.

Validity and reliability of the Turkish version of the 20-item jaw functional limitation scale.

PURPOSE: This study aimed to translate the 20-item Jaw Functional Limitation Scale (JFLS-20) into Turkish (JFLS-20-TR) and investigate the psychometric properties of the JFLS-20-TR. METHODS: This study included 232 patients with temporomandibular disorder (TMD) and 130 individuals without TMD. Structural (with confirmatory factor analysis [CFA]), convergent (with pain intensity, Fonseca Anamnestic Index [FAI], and Oral Health Impact Profile [OHIP-14]), discriminant (with maximum mouth opening [MMO]) and known-group validity were investigated to assess the construct validity. Cronbach's alpha for internal consistency and the intraclass correlation coefficient (ICC2,1) for test-retest reliability were calculated. Additionally, content and face validity, smallest detectable change (SDC95), and floor/ceiling effects were evaluated. RESULTS: According to CFA, the model fit indices were acceptable for JFLS-20-TR, confirming structural validity. Strong correlations were found between the global and subdomain scores of the JFLS-20-TR and pain intensity (r ≥ 0.80), FAI (r ≥ 0.83), OHIP-14 (r ≥ 0.76), and MMO (r ≥ -0.79) scores, confirmed the convergent and discriminant validity of the JFLS-20-TR. In addition, JFLS-20-TR differentiated between patients with TMD and individuals without TMD (p < .05). Internal consistency (Cronbach's alpha values: 0.91-0.93) was excellent, and test-retest reliability (ICC2,1 values: 0.91-0.95) was high. Content and face validity were satisfactory. The SDC95 values ranged from 0.79 to 1.43. No floor or ceiling effects were observed. CONCLUSION: The JFLS-20-TR is a valid, reliable, and useful tool for assessing jaw functional limitations in Turkish-speaking patients with TMD.

Validity and reliability of the Modified Four Square Step Test in individuals with ankle sprain.

BACKGROUND: Postural instability and gait abnormalities are frequently observed after an ankle sprain. A modified Four Square Step Test (mFSST) was developed to assess dynamic balance during gait. The aim of this study was to evaluate the reliability and validity of the mFSST in individuals with ankle sprains. METHODS: The study included 39 individuals with grade 1 and 2 ankle sprains with a mean age of 30.36 ± 6.21 years. The dynamic balance of the participants was assessed with the mFSST and Timed Up & Go test (TUG). To determine the test-retest reliability of the mFSST, the test was repeated approximately 1 h apart. RESULTS: The test-retest reliability of the mFSST was excellent (ICC = 0.85). Furthermore, when the concurrent validity of the mFSST was examined, a high correlation was found between with the TUG (r = 0.78, p < 0.001). CONCLUSION: The mFSST is a valid and reliable clinical assessment method for evaluating dynamic balance during walking in individuals with ankle sprains. We think that the mFSST is preferable in clinical evaluations because its platform is easy to prepare and requires very little equipment.

The Reliability and Validity of the Modified Four Square Step Test in Individuals with Anterior Cruciate Ligament Reconstruction.

Background: The modified four square step test (mFSST) is frequently used in the evaluation of dynamic balance in individuals with balance problems. However, the reliability of the mFSST has not been examined in individuals undergoing anterior cruciate ligament reconstruction (ACLR) surgery. Purpose: The aim of this study was to examine the test-retest reliability of the mFSST in individuals undergoing ACLR surgery. Methods: Forty-eight patients who had ACLR surgery were included in this study. Patients performed a total of four mFSSTs, two times each, by two different raters over seven days. Results: In the current study, the mFSST demonstrated excellent test-retest and inter-rater reliability. The intraclass correlation coefficient for mFSST was 0.92. The standard error of measurement and minimal detectable change for mFSST were 0.15 and 0.41, respectively. Conclusion: The mFSST has excellent test-retest and inter-rater reliability in patients with ACLR. It is a valid and reliable tool for evaluating dynamic balance in patients with ACLR. We think that mFSST, which is a clinical evaluation test, can be preferred because it is easy to score and does not require special equipment.

Predictors of the masticatory muscle activity during chewing in patients with myogenous temporomandibular disorder.

OBJECTIVES: The aim of the study was to identify predictors of the masticatory muscle activity during chewing (MMA) of the masseter and temporalis anterior (TA) muscles in patients with unilateral myogenous temporomandibular disorder (mTMD). MATERIALS AND METHODS: This observational and cross-sectional study included 109 patients diagnosed with unilateral mTMD. Surface electromyography was used to separately evaluate the MMA of the masseter and TA on the affected and unaffected sides. Also, pain intensity (with a visual analog scale), pressure pain threshold (with an algometer), active pain-free maximum mouth opening and temporomandibular joint lateral movements (with a ruler), cervical range of motions (with a goniometer), and TMD severity (with a Fonseca Anamnestic Index) were assessed. Various statistical methods were used to predict the MMA of the masseter and TA, including standard, forward, and best subsets multiple regression models. RESULTS: While there were significant correlations between the MMA of the masseter and TA and pain intensity, pressure pain threshold values, and TMD severity, they were not found with other variables. These parameters were also predictive factors for MMA of both muscles (p < 0.05). CONCLUSIONS: According to the present study, pain intensity, muscle and joint tenderness, and the severity of the disorder are predictive factors for MMA of the masseter and TA muscles in patients with mTMD. It is recommended that these parameters be considered when establishing clinical evaluation and treatment programs focusing on MMA in patients with mTMD. CLINICAL RELEVANCE: The pain intensity, masticatory muscles and TMJ tenderness, and disorder severity are predictors for MMA of the masseter and TA in patients with mTMD. Pain intensity has the most significant importance.

Validity and Reliability of the Turkish Version of Mandibular Function Impairment Questionnaire.

OBJECTIVE: To assess the validity and reliability of the Turkish version of the Mandibular Function Impairment Questionnaire (MFIQ-TR). METHODS: Included in this study were 248 patients diagnosed with temporomandibular disorder (TMD) according to Diagnostic Criteria for TMD Axis I protocol. Construct-related validity was evaluated through internal and external construct validity; convergent and divergent validities were evaluated by the average variance extracted (AVE), composite reliability (CR), and bivariate correlations between factors. Reliability was assessed by internal consistency and test-retest reliability. RESULTS: All items of the MFIQ-TR had content validity and factor loadings above 0.5. The model statistics indicated a good fit. The convergent validity was very good (AVE > 0.5 and CR > 0.7), and the discriminant validity was satisfied. Internal consistency and test-retest reliability of the MFIQ-TR were excellent. CONCLUSION: The MFIQ-TR is a valid and reliable instrument for evaluating the impairment of mandibular function in Turkish patients with TMD.

Retinal Nerve Fiber Layer Thickness Alterations after Electroconvulsive Therapy in Patients with Mental Illness.

BACKGROUND: We hypothesized that the ongoing neurotrophic effects of electroconvulsive therapy (ECT) might be detected in the retinal nerve fiber layer (RNFL) using optical coherence tomography (OCT). METHODS: This study was conducted using a prospective design. The RNFL thickness alterations of 18 psychiatric patients undergoing ECT were assessed using OCT. The results were compared with the RNFL thicknesses of 18 age and gender-matched healthy controls. RESULTS: In the left eye, the average RNFL (p = 0.025), superior quadrant (p = 0.029), and nasal quadrant (p = 0.021) thicknesses were significantly increased after the last ECT treatment. In contrast to the right eye, the basal left-eye superior RNFL thickness (p = 0.038) and inferior quadrant (p = 0.007) thicknesses were significantly lower in the patients than in the healthy controls. CONCLUSION: Here, we have revealed a significant lateralized influence of ECT on the left-eye RNFL. However, larger case series should be conducted before interpreting our current findings.

Reliability and validity of the Turkish version of the Foot Function Index in patients with foot disorders

Background/aim: The Foot Function Index (FFI) is a valid, reliable, and widely used self-reported questionnaire for the foot. The purpose of this study was to provide evidence for the validity and reliability of the Turkish version of the FFI (FFI-TR) among patients with foot disorders such as plantar fasciitis, hallux valgus, pes planus, and hammertoe deformities. Materials and methods: One hundred and fifty-nine patients with foot disorders were enrolled. The psychometric properties of the previously translated and adapted FFI-TR were assessed. The internal consistency and test-retest reliability were evaluated. Construct validity was examined for correlations with the Short Form-36 (SF-36) questionnaire. Results: Cronbach's alpha ranged between 0.821 and 0.938. Reproducibility was satisfactory, with intraclass correlation coefficient values between 0.960 and 0.985. Weak correlations were found between FFI-TR and some SF-36 subscales for validity (|rho| < 0.30). There was a ceiling effect for the activity limitation subscale. There were no floor effects for any items or application times. Good accuracy was determined for all scores. Conclusion: FFI-TR is a reliable and valid scale. This tool can be used in routine practice and clinical research for evaluating foot disorders and foot-related functional impairments.

Decreased Expression of α-Synuclein, Nogo-A and UCH-L1 in Patients with Schizophrenia: A Preliminary Serum Study.

OBJECTIVE: α-synuclein, Nogo-A and Ubiquitin C-terminal hydrolase L1 (UCH-L1) have neuromodulatory roles for human brain. Therefore, abnormalities of these molecules are associated with neuropsychiatric disorders. Although some serum studies in the other disorders have been made, serum study of α-synuclein, Nogo-A and UCH-L1 is not present in patients with schizophrenia and healthy controls. Therefore, our aim was to compare serum levels of α-synuclein, Nogo-A and UCH-L1 of the patients with schizophrenia and healthy controls. METHODS: Forty-four patients with schizophrenia who is followed by psychotic disorders unit, and 40 healthy control were included in this study. Socio-demographic form and Positive and Negative Syndrome Scale (PANSS) was applied to patients, and sociodemographic form was applied to control group. Fasting bloods were collected and the serum levels of α-synuclein, Nogo-A and UCH-L1 were measured by ELISA method. RESULTS: Serum α-synuclein [patient: 12.73 (5.18-31.84) ng/mL; control: 41.77 (15.12-66.98) ng/mL], Nogo-A [patient: 33.58 (3.09-77.26) ng/mL; control: 286.05 (136.56-346.82) ng/mL] and UCH-L1 [patient: 5.26 (1.64-10.87) ng/mL; control: 20.48 (11.01-20.81) ng/mL] levels of the patients with schizophrenia were significianly lower than healthy controls (p<0.001). CONCLUSION: Our study results added new evidence for explaining the etiopathogenesis of schizophrenia on the basis of neurochemical markers.

Total Tau and Phosphorylated Tau Protein Serum Levels in Patients with Schizophrenia Compared with Controls.

Tau protein is located in the axons of neurons and in Alzheimer Disease, is abnormally phosphorylated and aggregates into paired helical filaments (neurofibrillary tangles) reflecting the degree of neurofibrillary pathology and neurodegeneration. Although tau and phosphorylated tau (p-Tau) pathology is a hallmark for dementia, few studies were performed in patients of schizophrenia. This preliminary serum study was designed to compare serum total tau and p-Tau levels of schizophrenia patients with healthy controls. The study was included 42 patients diagnosed with schizophrenia and 42 healthy control subjects. Sociodemographic form was applied to both groups and PANSS was applied to patient group. Serum total tau and p-Tau levels were measured by ELISA method. Total tau and p-Tau levels of patients were significantly lower than healthy controls. There was a positive correlation between amount of past electroconvulsive therapies and total tau level. However total tau and p-Tau levels were positively correlated. Our study results showed that serum total tau and p-Tau levels of patients with schizophrenia were significantly lower than healthy controls.

Effectiveness of ultra-rapid dose titration of clozapine for treatment-resistant bipolar mania: case series.

Treatment of severe and refractory manic episodes in hospital settings can occasionally be very difficult. In particular, severely excited patients showing aggressive, hostile, impulsive behaviours frequently require physical restraint and seclusion, high doses of antipsychotics and benzodiazepines, and sometimes, electroconvulsive therapy. Hospital stay is generally prolonged and such patients cause great emotional distress for other patients in the ward and clinical staff involved in their care. Here we report on three patients with a diagnosis of bipolar disorder and one patient with a diagnosis of schizoaffective disorder bipolar subtype, all of whom were hospitalized for severe manic episodes with psychotic features. These patients were extremely difficult to manage in the ward as no response could be obtained in the first week of treatment despite high doses of antipsychotics and benzodiazepine administration. The introduction and rapid titration of clozapine proved remarkably effective and was well tolerated in the acute management of these patients. We observed that clozapine had a superior and fast mood stabilization effect with rapid titration and could be extremely helpful in the management of such patients.